<!DOCTYPE html>
<html>
<meta charset="utf-8">
<head th:include="include :: header"></head>
<body class="gray-bg">
	<div class="wrapper wrapper-content ">
		<div class="row">
			<div class="col-sm-12">
				<div class="ibox float-e-margins">
					<div class="ibox-content">
						<form class="form-horizontal m-t" id="signupForm">
						<input id="tid" name="tid" th:value="${bizCustomerPay.tid}"  type="hidden">
							<div class="form-group">	
								<label class="col-sm-3 control-label">客户号：</label>
								<div class="col-sm-8">
									<input id="custId" name="custId" th:value="${bizCustomerPay.custId}" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">缴费日期：</label>
								<div class="col-sm-8">
									<input id="payDate" name="payDate" th:value="${bizCustomerPay.payDate}" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">失效日期：</label>
								<div class="col-sm-8">
									<input id="expireDate" name="expireDate" th:value="${bizCustomerPay.expireDate}" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">缴费金额：</label>
								<div class="col-sm-8">
									<input id="payAmt" name="payAmt" th:value="${bizCustomerPay.payAmt}" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">办公整机维护：</label>
								<div class="col-sm-8">
									<input id="servZjwhFee" name="servZjwhFee" th:value="${bizCustomerPay.servZjwhFee}" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">税控器具报税：</label>
								<div class="col-sm-8">
									<input id="servRkqjbrFee" name="servRkqjbrFee" th:value="${bizCustomerPay.servRkqjbrFee}" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">电子申报：</label>
								<div class="col-sm-8">
									<input id="servDzsbFee" name="servDzsbFee" th:value="${bizCustomerPay.servDzsbFee}" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">纸质申报：</label>
								<div class="col-sm-8">
									<input id="servZzsbFee" name="servZzsbFee" th:value="${bizCustomerPay.servZzsbFee}" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">代领发票：</label>
								<div class="col-sm-8">
									<input id="servDlfpFee" name="servDlfpFee" th:value="${bizCustomerPay.servDlfpFee}" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">代打印发票：</label>
								<div class="col-sm-8">
									<input id="servDdyfpFee" name="servDdyfpFee" th:value="${bizCustomerPay.servDdyfpFee}" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">代理记账、理账：</label>
								<div class="col-sm-8">
									<input id="servLsjzFee" name="servLsjzFee" th:value="${bizCustomerPay.servLsjzFee}" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">合计：</label>
								<div class="col-sm-8">
									<input id="annualFee" name="annualFee" th:value="${bizCustomerPay.annualFee}" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">会员状态,1有效，0无效：</label>
								<div class="col-sm-8">
									<input id="activeStatus" name="activeStatus" th:value="${bizCustomerPay.activeStatus}" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">创建人：</label>
								<div class="col-sm-8">
									<input id="createBy" name="createBy" th:value="${bizCustomerPay.createBy}" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">：</label>
								<div class="col-sm-8">
									<input id="createDate" name="createDate" th:value="${bizCustomerPay.createDate}" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">数据状态：</label>
								<div class="col-sm-8">
									<input id="state" name="state" th:value="${bizCustomerPay.state}" class="form-control" type="text">
								</div>
							</div>
														<div class="form-group">	
								<label class="col-sm-3 control-label">备注：</label>
								<div class="col-sm-8">
									<input id="remark" name="remark" th:value="${bizCustomerPay.remark}" class="form-control" type="text">
								</div>
							</div>
																					<div class="form-group">
								<div class="col-sm-8 col-sm-offset-3">
									<button type="submit" class="btn btn-primary">提交</button>
								</div>
							</div>
						</form>
					</div>
				</div>
			</div>
	</div>
	</div>
	<div th:include="include::footer"></div>
	<script type="text/javascript" src="/js/appjs/system/bizCustomerPay/edit.js">
	</script>
</body>
</html>
